Neuro-ophthalmic imaging and visual assessment technology for spaceflight associated neuro-ocular syndrome (SANS)

Spaceflight associated neuro-ocular syndrome (SANS) refers to a unique collection of neuro-ophthalmic clinical and imaging findings observed in astronauts after long-duration space-flight. Current in-flight and postflight imaging modalities (e.g., optical coherence tomog-raphy, orbital ultrasound, and funduscopy) have played an instrumental role in the un-derstanding and monitoring of SANS development; however, the precise etiology for this neuro-ophthalmic phenomenon is still not completely understood. SANS may be a poten-tial barrier to future deep space missions, and therefore it is critical to further elucidate the underlying pathophysiology for effective countermeasures. The complexity and unique limitations of spaceflight require careful consideration and integration of leading technol-ogy to advance our knowledge of this extraterrestrial syndrome. We describe the current neuro-ophthalmic imaging modalities and hypotheses that have improved our current un-derstanding of SANS, discuss newer developments in SANS imaging (including noninvasive near-infrared spectroscopy) and summarize emerging research in the development of an as-pirational future head-mounted virtual reality display with multimodal visual assessment technology for the detection of neuro-ocular findings in SANS.(c) 2022 Elsevier Inc. All rights reserved.